Revista Iberoamericana de las Ciencias de la Salud
ISSN: 2395-8057
FILOSOFÍA DE LA CIENCIA DEL CUIDADO
Analogía del mito de la caverna de Platón con la
profesión de enfermería
PHILOSOPHY OF SCIENCE OF CARING
The Allegory of the Cave by Plato with the nursing profession
María Guadalupe Díaz Rentería
Universidad de Guadalajara
[email protected]
RESUMEN
Platón en el famoso mito de la caverna brinda una explicación alegórica de la situación en
la que se encuentra el hombre con respecto al conocimiento y concluye que el
razonamiento filosófico proporciona el conocimiento de las ideas, que es el fin más
elevado de la existencia humana.
La enfermería es una ciencia humanística, práctica, en constante desarrollo conforme
cambian los procesos etnográficos, epidemiológicos, sociales, culturales y económicos de
los individuos, familias, grupos y colectividad. Es una profesión joven pero cuyas raíces
nacen con la humanidad, por lo que se puede decir que es un arte milenario del cuidado,
que ha evolucionado desde su práctica empírica, hasta el desarrollo de teorías y filosofía
propias. Con el cuidado como eje central, utiliza para ello los metaparadigmas: salud,
persona, entorno y enfermería, así como un lenguaje común y estandarizado denominado
NANDA I, NIC, NOC.
Palabras clave: proceso, atención de enfermería, filosofía.
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Revista Iberoamericana de las Ciencias de la Salud
ISSN: 2395-8057
Abstract
Plato in the famous myth of the cave provides an allegorical explanation of the situation in
which is located the man with respect to knowledge and concludes that the philosophical
reasoning provides knowledge of ideas, which is the high end of human existence.
Nursing is a humanistic, practical, science in constant development as ethnographic,
epidemiological, social, cultural and economic processes of individuals, families, groups
and community change. It is a young profession but whose roots are born with mankind,
so can say that is an ancient art of care, which has evolved from its empirical practice, to
develop own theories and philosophy. With care as the central axis, so using the
paradigms: person, environment, health and nursing, as well as a common and
standardized language called NANDA I, NIC, NOC.
Key Words: process, nursing, philosophy.
Fecha recepción: Octubre 2012
Fecha aceptación: Diciembre 2012
La ciencia es la creencia en la ignorancia de los expertos.
Richard Feynman
Introduction
Nursing is as old as humanity, as science his field ontological is be holistic, comprehensive,
unique and unrepeatable; his philosophy is humanistic and his science is art and
technique. Nursing is considered to be the science of care.
From the teachers of Greek philosophy Plato was taken as reference, in particular the
myth of the cave contained in Book VII of the Republic, making an analogy between the
myth and the nursing profession; at the same time, are expressed concisely without being
exhaustive, some aspects of the philosophy of nursing science.
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Revista Iberoamericana de las Ciencias de la Salud
ISSN: 2395-8057
The Allegory of the Cave by Plato with the nursing profession
Plato was disciple of Socrates, the Greek philosopher. In his book "Republic VII or
Concerning Justice", written in the 5th century b.c. as part of the dialogues, explains the
State of man that lives in the shadows, sees imperfect copies of reality which are vague
perceptions. When the man comes out of that darkness to the outside world, the one of
ideas, it elevates his human existence.
THE ALLEGORY OF THE CAVE
The darkness
A WORLD OF ILLUSIONS, LIES, ERRORS, FULL OF IGNORANCE, PASSIONS, FEARS,
PREJUDICES, PRODUCT MOULDS OR IDEAL FIGURES, A REALITY THAT ISN'T REAL. He
describes human beings chained in the depths of a cave, with a limited vision, where they
can only visualize what they have in front of them, sometimes by the action of a fire pit
behind them in the midst of darkness. They see reflected shades of animals or objects,
they hear voices, live in an unreal world, but for them, that is the reality.
From darkness to light
THE KNOWLEDGE OF REALITY AS A LIBERATING PROCESS, THE LIGHT OF THE WORLD OF
IDEAS, THE PERSONAL EFFORT OF ACCOMODATION, PATIENCE, PERSEVERANCE, VISION
OF THE REAL OBJECTS, THE ESSENCE OF THE TRUTH, PURE DIALECTICS.
One of them comes to light of day, but not before overcoming a series of obstacles in a
rough way, the way out is difficult and dangerous. Upon leaving the cave, he sees only
shadows are reality, seeing the sunlight that illuminates the environment discover the
reality of a world of color, texture, volume. See the sun in all its glory (the world of big
ideas) and discovers that in the caves only see shadows, distorted copies of reality. The
transition is not easy, it is hard to get used to this new reality as their old reality was a
world of shadows. Be aware of who he is and that is different from others.
Return of light to darkness, to achieve a shared and lasting light
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Revista Iberoamericana de las Ciencias de la Salud
ISSN: 2395-8057
THE RETURN, THE SHARE OF REALITY
The man reminded the world where he lived, reminds his fellow prisoners held between
space-time feel sorrow for their reality in that world of shadows, so consider two options:
return to the previous state of shadows, where the rehabilitation process would traumatic
and painful, or return to the cave to explain to others that they see are only shadows and
appearances, there is a real world out there. However, it runs the risk of being
misunderstood, no one would believe him, he would be considered crazy because it is not
like them, or kill for their different ideas. Back to the cave is a risk to his life, but believes
that the man who has seen the true will and well-know risk that gives meaning to their
existence.
The nursing profession
Darkness
DAILY WORLD, THE BELIEF
The development of nursing knowledge has been built since ancient times where
knowledge is transmitted orally, mainly from mother to daughter; It is what is known as a
domestic stage where health was conceived as the maintenance of life.
In the Middle Ages, especially in the religious sphere, vocational stage where health was
considered a religious value of love for fellow emerged:
"Then the King will say to those on his right, 'Come, blessed of my Father, inherit the
kingdom prepared for you from the foundation of the world. For I was hungry and you
gave me food; I was thirsty and you gave me drink; I was a stranger and you welcomed
me; I was naked and you clothed me; sick, and you visited me; in prison, and you came to
me. Then the righteous will answer him, 'Lord, when did we see you hungry and feed you,
or thirsty and give you drink? And when did we see you a stranger and welcome you, or
naked and clothe you? When did we see you sick or in prison, and came unto thee? And
the King shall answer and say unto them, Verily I say to you, whatever you did for one of
these my brethren, you did it to me.” (Mateo 25:34-40 Versión Reyna Valera 1960)
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Revista Iberoamericana de las Ciencias de la Salud
ISSN: 2395-8057
At this time the focus is on the care and regulation is necessary. In 1269, the Dominican
monk Humbert of Romans wrote the book De officciis ordinis praedicatorum. In Chapter
27, defines the nurse and its scope, knowledge about the care and therapeutic remedies
(SABER); its competition in terms of trade in relation to patient care and nursing (DO); and
you must possess the qualities of the relationship and dealing with patients, establishing
personal attention (SER). Gives a hierarchy of care, where a nurse takes responsibility for
nursing and other assigned patients in particular.
From darkness to light
Scientific knowledge
Professional Nursing born in the late nineteenth century with Florence Nightingale, who
felt that nursing was a vocation that required intelligent fit subjects to which they must
compensate them for the quality of its services
During this stage of nursing technique where health is defined as the absence of disease,
they begin the principles and practices of modern nursing,
Nursing epistemology has been built up over time, while the professional stage of nursing
began in the last 50 years. Disciplining growth boomed with the development of models
and theories that have given birth to the essence and reason for nursing, through the
development of a discipline theoretical framework and a holistic philosophy of care is now
called the nursing science or science of care.
The different theories and models of nursing define metaparadigms health, person,
environment and nursing. Here comes a common language and standardized NANDA I
called, NIC, NOC; ie diagnoses, interventions and nursing outcomes, where the nurse is
directly responsible to predict, prevent and treat independently the patient, family, group
or community, while professional skills are defined and the delimitation the scope that
enables social recognition, independent and collaborative practice.
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Nursing research is concerned with generating new knowledge through scientific and
systematic process, which allowed substantial clarify the nursing process.
From light to darkness, to achieve a shared and lasting light
COMMUNICATING WHAT IS DISCOVERED
To speak nursing is necessary to define in nursing through history has been defined in
different ways. Today we can define it as: humanistic science, practice constantly
developing as they change ethnographic, epidemiological, social, cultural and economic
processes of individuals, families, groups and community, in order to achieve
comprehensive health care with better conditions, styles and lifestyles. It counts with a
theoretical framework of abstract knowledge and an international language called NANDA
I, NIC, NOC, with the methodological support of nursing based on evidence which is
developed by a professional health sciences, with values and beliefs which focuses on the
individual's care and the environment, linking science and humanism.
The professional health sciences, practice nursing skills has intellectual knowledge and
belief, conducts technical-political educational technical assistance, administrative,
educational and research based on scientific knowledge, and acquired during their
training. That way, you can provide quality services to individual, family and community, in
order to increase the quality of life, counting with a diagnosis of the needs, problems and
demands of health care.
Nursing is a young profession although its roots are born with humanity, so we can say
that is an ancient art of care; where there is a healthy person sick or there will be nursing.
Duran (2002) defines the epistemological framework of nursing as "the knowledge
generated from the development of discipline kernel itself in response to the needs of
professional practice".
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Marrinier (2007) mentions that nursing theories promote understanding and analysis of
related phenomena that science and, in turn guide the scholar development of nursing
practice through research.
During the twentieth century, international care and nursing science is consolidated,
human being answers their specific field of action, and be the ontic foundation of the
profession.
Barbara Carper (1976) defines four fundamental concepts or patterns in the field of
nursing.
Empirical knowledge (science of nursing)
Aesthetic knowledge (Art nursing)
Moral knowledge (Ethics of nursing)
Personal knowledge (Therapeutic use of the self).
Characteristics of the nursing profession
own theories and nursing models,
-I), Nursing Interventions (NIC), Nursing
Outcomes (NOC)
ists, therapists,
and so on.
PHILOSOPHY OF SCIENCE OF NURSING
The philosophy is the "quest for knowledge"; by its etymological roots is "love of wisdom"
and can be defined as the science to investigate the causes and laws underlying reality.
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The branches of philosophy, among others, are: logic, ethics, aesthetics, epistemology,
metaphysics, axiology, politics and so on.
The philosophy deals with the quest to understand the correct procedure of reasoning,
understanding of reality and absolute truth about human beings, deities and the world
and determining the right way to live.
Nursing benefits of philosophy, since it governs its methods through logic and ethics (Silva,
1977)
Epistemology is concerned with the theory of knowledge in philosophical research, and
science of nursing has been characterized by two philosophical branches: rationalism and
empiricism (Marrinier, 2007)
Erick Landeros-Olvera (2009) reports that as philosophical positivism is prevailing in
nursing and its influence is quite marked in hospital practice to use the scientific method
also mentioned that the process of nursing care (PAE) positivist method is derived directly
from the scientific method in the profession.
Similarly, Benner, quoted by Ariza (2007) mentions that the nursing philosophy is oriented
towards a reductionist mechanistic view reflecting reactivity, prioritizes knowledge or
structure, or focuses on human beings and their experience, to seek to understand its
meaning, interpretation, worry and living situations.
"The object of study of the profession is nursing care man, family and community healthy
and / or diseased in interaction with their social environment and based on human needs
and their satisfaction through the implementation of the Process Nursing Care under a
materialistic dialectical prism. "(Puga, 2007)
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Silva, taken by Benner (1997), conceived the infirmary with an integrated approach and
dialogue in the ontology, epistemology, ethics and aesthetics can enrich and shape the
theoretical and scientific research in nursing.
Bunge (2000) reports that science is art and art and scientific realism rivals the main
schools of philosophy of knowledge:
The radical rationalism of Leibniz or irrationalism of Heidegger,
Husserl subjectivism and idealism skepticism of Hume,
The pragmatism of James and intuitionism of Bergson,
Bach logical empiricism or the radical empiricism of Berkeley,
In ordinary language of Wittgenstein and Popper's critical rationalism,
Duhem's conventionalism constructivism-relativism of Latour.
Research, development theory and practice based on the knowledge gained through the
first two, are the axes around which revolves the epistemology of nursing (Duran, 2002),
hence that nursing is considered an applied discipline .
"The goal of the nurse is to promote health, production changes to promote wellness,
using as a philosophy of nursing a proposal that includes systemic approach to
components: human beings, environment, health, nurse and nursing. "(Agramonte, 2007)
Purpose of philosophy in nursing
•
Understanding the reasons and fundamental relations of humans and the
environment,
•
Focus nursing as a scientific discipline,
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•
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Develop a personal system of beliefs about human beings, the environment, health
and nursing as a process.
Importance of philosophy for nursing
•
Please keep your belief system,
•
The guide in obtaining ethical goals in education, practice and research,
•
Governs the development of the theoretical basis of nursing practice.
Table 1. Relationship between nursing care process, method of problem solving and
the scientific method
Nursing process
Rating: collection and data
review
Diagnosis: Data analysis to
identify human and
pathophysiological
responses
Planning: development plan
Execution: implementation
of the plan
Rating: decision of the
effectiveness of the plan.
Troubleshooting method
Problem: collects
information
Analysis: studies and
analyzes information
Scientific method
Problem and theoretical
framework
Hypothesis formulation,
definition of variables
Action plan: plan design
Execution: performs the
action plan
Evaluation: of results.
Planning activities
Data collection and
information processing
Statistical analysis,
suggestions, conclusions,
diffusion.
The application of the scientific method, the clinical method and the procedure for solving
problems in nursing come together in the SAP, which aims to meet the general and
specific health care needs of patients requiring nursing by an individualized plan of care
agreement to human and pathophysiological responses present, making it easy to nurse
caregiving in a holistic, systematic and rational achieving patient satisfaction as being
holistic, unique and complex.
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The nursing process is the instrument that allows streamline the work of nursing because
it allows you a critical, logical and reflective thinking of all its activities, preventing
automation in developing them.
Therefore, you can define the EAP as dynamic and flexible approach systematic,
interactive, humanist, intentional, based on nursing theories and models; that can
diagnose and provide individualized holistic care rational, logical and systematic way
based on human responses.
Méthod  series of mental steps that organize their work and solve problems related to
the user's health.
Systematic  logical sequence leading to achievement of results.
Interactic  human-human relationship is needed to agree and achieve objectives.
Humanist  considers man as being holistic.
Deliberate  focuses on the achievement of objectives, it will help guide the actions to
solve the problem or reduce risk factors and evaluates the capabilities of nurses and users.
Dynamic  It presents continuous changes that are due to the very nature of man.
Flexible  It applied to different contexts and with different theories and nursing models.
Theoretical Base  They are a set of theories and models interrelated propositions and
definitions presented metaparadigms perspectives of nursing; person-environment-healthnursing-care, specifying the relationship between its most important variables.
Human responses  are the ways in which the user responds to a state of health or
disease, and includes feelings, behaviors, perceptions and physiological reactions, which
are many and personal and arise from human needs and interaction with their environment.
The nursing care process allows us to develop critical thinking, which is defined as: thought
to the examination and evaluation of the beliefs and actions. Allows us to choose what to
accept and what to reject, where we use previous experiences and information sources as
points of reference, an organized using various thinking strategies to find and gather
reliable information that allows us to use it as evidence or reasons underlying our critical
judgments . In other words, critical thinking is "that kind of thinking that allows us to make
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decisions based on scientific evidence, the experience and the needs and preferences of our
users." (Knight, 2010)
Table 2. Relationship between philosophy and process of nursing care Leddy and
Pepper (1989)
AREAS OF PHILOSOPHY
Knowledge
Values
Existence (metaphysics)
NURSING PROCESS
Scientific method, logical thinking
Code of ethics
Nurse and patient are human beings
CONCLUSIONS
Nursing is a science and ancient art based on a recent theory discipline where nurses
demonstrate their theoretical, clinical and human knowledge through practice. Therefore,
you can not pigeonhole any philosophical decision as important as each of them to
develop their own, based on disciplinary knowledge. Disciplinary knowledge of the science
of care is developed through research, the SAP facilitates sharing aspects of practice using
critical thinking based on scientific knowledge.
Science or nursing care science is inclusive; theories and models provide the theoretical
framework of the profession, which increases with the development of applied research
into the phenomena of nursing derived and lead to philosophy. The nursing staff through
critical contributes to the development of epistemology of nursing as it investigates the
origin, development, structure, construction of knowledge, methods thought, ethical,
aesthetic, logical, practical to be used, and how generate and evaluate nursing based on
experience (practical knowledge), the (theoretical knowledge) scientific evidence, ethics
and moral evidence (how to be).
Finally, it is important to note that nursing is a professional discipline in constant
development philosophy which sets the standard of knowledge that can provide quality
care based on evidence on the health and disease of individual, family, group and
community.
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